Should you take these new miracle drugs for weight loss?

Do you sometimes run into (mostly well-off) people who have suddenly lost a lot of weight?

And when you ask them how they managed it, the answer is always vague: “working out a bit”, or “eating healthily” or something like that?

 

This might have been convincing if the people in questions were athletic in temperament.  Or if they had previously demonstrated the will power required to restrict their diets. But as most of them do not seem to have changed their lifestyles or habits, you begin to wonder how they did it.

 

   The answer, more often than not, is just one word: Semaglutide.

 

   If you haven’t heard of Semaglutide, which is now a global rage, here is what it is. It’s a drug that affects our satiety centres and tells us that we are full even if we have only eaten a relatively small quantity of food. If you take Semaglutide for a while, you might find that you crave all food much less. You may even not want to drink much alcohol.

 

   In other words, the drug can take a very greedy person and turn him or her into an abstemious sort who eats relatively little and always wastes that second drink.

 

   It is to fatties what Viagra was to impotent men. (There, I’ve said it.)

 

   There is a long and slightly tiresome medical history behind the discovery and creation of Semaglutide. One popular version has it that scientists were intrigued by a desert lizard that could go for days without food. They isolated the chemical that allowed the lizard to do it and reproduced in the laboratory. Then they created a synthetic version that could affect human appetite.

 

   When the drug was first introduced it was meant for diabetics because it has shown dramatic results in treating Type II Diabetes. But as time went on, doctors discovered that patients on Semaglutide not only ate less, they also lost interest in food halfway through a meal.

 

   Speaking for myself, I have a slight problem with my sugars but am fortunate to have a doctor, Ambrish Mithal, who is always at least one stage ahead of the game and knows exactly what current international trends are.

 

   So Dr Mithal put me on oral Semaglutide and we waited to see what happened. To our surprise, it made no difference to my sugars and my weight actually went up.

 

   Dr. Mithal then came to the conclusion that perhaps I needed injectable Semaglutide. This has become a craze in the US under such brand names as Wegovy and Ozempic. Every movie star is taking it and the tabloids play a regular guessing game: who is taking it now? Was Oprah on Ozempic? (Yes). Was Meghan Markle on the drug?  (Possibly.)

 

   This sounded great. It was just one injection a week though the adjustment of the Oxempic syringe to deliver the right dose can be a nuisance if you have to do it yourself. (No doubt, celebrities get nurses and doctors to do it for them.)

 

   There is a second problem. You can’t get Ozempic without prescription. It’s not available in India and most doctors abroad will insist on a full medical check up before prescribing it. So I found a doctor in Thailand who checked me out, said it was safe for me to try it and issued a prescription.

 

   It worked. My sugars remained in check. My appetite reduced and a few ounces of fat said reluctant goodbyes to my belly.

 

"You can buy injectable Semaglutide in many neighbouring countries — though please make sure you get a prescription from a local doctor."

   But here’s the thing that they don’t always tell you: there can be nasty side-effects. Nausea is the most common. But a friend of mine in California had a serious stomach issue. And I began to feel mental consequences. I was always anxious and irritable. I hasten to add however that most of the people I know who have taken injectable Semaglutide have had no serious long term side-effects at all and have lost weight.  But I am the sort of guy who reacts badly to most medicines.

 

   The makers of Ozempic and Wegovy now concede that these side-effects have been discovered in some patients but not in enough of them to cause serious concern. All medicines have side effects etc.

 

   Meanwhile, I had discovered Dr. Jawad at the fancy Dubai Mediclinic. Dr. Jawad is one of the pioneers when it comes to using new drugs to treat diabetes and he suggested Tirzepatide which, he said, was one generation ahead from Semaglutide.

 

   So I tried that instead. It has kept my sugars in control even though I have given up my normal sugar medicine. And my appetite has reduced. Nor do I have any of the terrible side-effects that I associate with Semaglutide. Moreover Tirzepatide (trade name: Mounjaro) comes in easy-to-use individual syringes so it is easy to take every week.

 

   But of course, in this field, nothing is easy. Mounjaro is not available in most markets. (I couldn’t find it in Thailand. It is only just entering Europe etc.). So it is hard to get supplies outside of America and Dubai. And as half of the population of Dubai seems to be taking it, supplies fly off the shelves as soon as they are imported. Scoring a package of Mounjaro is considered a big deal in Dubai. (Even the Dubai Mediclinic where Dr Jawad sits, had run out when I went last week.)

 

   So, here is the situation, if you want Ozempic or Wegovy injections, you probably won’t get them in India. Dr. Mithal now says that the dose of oral Semaglutide I was on was too low and that higher oral doses are more effective. So that’s one option.

 

   You can buy injectable Semaglutide in many neighbouring countries — though please make sure you get a prescription from a local doctor. Mounjaro is the holy grail. Theoretically available in Dubai but almost impossible to get.

 

   And anyway, should you take these new miracle drugs? If you have diabetes and a doctor prescribes them, then yes, of course you should.

 

   Weight loss is slightly more complicated. In the US both Semaglutide and Tirzepatide are now approved for weight loss and the UK wants to put Semaglutide on the National Health to fight the obesity epidemic. So I guess the new consensus is: take the injections and lose weight.

 

   My view, as a layman, is that in the next two years, people will start using these drugs in the same way that we use Viagra or Propecia. Perhaps scientists will be able to re-engineer Semaglutide so that the side-effects are minimised.  And the makers of Ozempic will learn how to make a stress-free syringe from the Mounjaro people. Both injectable Semaglutide and Mounjaro will either be legally imported into India or will be manufactured here.

 

   This will almost certainly have consequences for the way we eat. The New York Times considered last week whether people on these new drugs would continue to crave junk food or snacks in the same way. Will you still want another Mars Bar? Another Magnum? Will you finally be able to stop yourself from eating a whole packet of potato crisps?

 

   The Times seemed to think that food manufacturers would have to rethink their approaches.

 

   Speaking personally, I am particularly relieved by one consequence. People who can afford to go to fancy tasting-menu restaurants are often men, who are overweight and diabetic or pre-diabetic. Many of them will go on these drugs. And then, they will get no further than the between-course sorbet in a set menu before feeling full and/or sick.  The age of the 20 course menu may finally be coming to an end.

 

   So, watch the progress of these drugs carefully. They have not really hit India yet. But they will. And many things will change.